Shortening Osteotomy and Sacro-sacral Fixation For U-shaped Sacral Fractures

Sabourin, M.; Lazennec, Jean-Yves; Catonné, Yves; Pascal‐Moussellard, Hugues; Rousseau, Marc-Antoine

doi:10.1097/bsd.0b013e3181bee88f

Cited by 16 publications

(7 citation statements)

References 19 publications

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“…Four case reports were found describing U-shaped fractures and their surgical treatment [13,21,32,33] as well as four case series [14,17,19,24]. All in all, four retrospective studies were found in the literature and included into this review [11,20,28,30].…”

Section: Resultsmentioning

confidence: 97%

“…Wound healing problems were noted in ten patients [11,24,28] of which eight required surgical washout, wound debridement and intravenous antibiotics, and one decubital ulcer due to metal work prominence needed surgical wound cleaning. All of these cases occurred in the open surgery group.…”

Section: Wound Complicationsmentioning

confidence: 99%

“…Ilio-sacral screw fixation as percutaneous osteosynthesis was performed in 20 (31.7%) of the U-shaped fractures in which the screws were either inserted unilaterally, bilaterally or trans-sacrally [17,20]. Another recently published treatment option is a shortening osteotomy and sacro-sacral plating in limited access surgery in 3 cases of U-shaped fractures (4.8%) [24].…”

Section: Limited Access and Minimal-invasive Techniquesmentioning

confidence: 99%

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Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies

König

Jehan

Boszczyk³

et al. 2011

Eur Spine J

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From the current available data, an evidence based treatment strategy regarding outcome, neurological recovery or fracture healing could not be identified. Limited access and minimal-invasive surgery focussing on sacral reduction and restoration seems to offer comparable results to large spino-pelvic constructs with fewer complications and should be considered as the method of choice. If the fracture is highly unstable and displaced, spino-pelvic fixation might offer better stability.

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Section: Resultsmentioning

confidence: 97%

Section: Wound Complicationsmentioning

confidence: 99%

Section: Limited Access and Minimal-invasive Techniquesmentioning

confidence: 99%

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Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies

König

Jehan

Boszczyk³

et al. 2011

Eur Spine J

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“…Established techniques included iliosacral screw fixation, transiliac rod fixation or plating, local (transsacral) plate osteosynthesis or a combination of triangular osteosynthesis using a vertical lumbopelvic fixation and a transverse fixation of the sacrum [2][3][4][5] .…”

Section: Resultsmentioning

confidence: 99%

“…Conventional operation approaches to unstable sacral fractures had such drawbacks as long incisions, long exposure time, much intraoperative blood loss, and large surgical trauma, which hinder the patients from recovery. The concern for the clinicians currently is how to diminish surgical wound, shorten operation time, and decrease perioperative complications, along with the popularity and development of minimal invasive surgery [2][3][4][5] . In this study, through percutaneous reconstruction plate internal fixation, satisfactory outcome have …”

Section: Introductionmentioning

confidence: 99%

Treatment of unstable sacral fractures with percutaneous reconstruction plate internal fixation

Chen

Liu

et al. 2012

Acta Cir. Bras.

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PURPOSE:To study the effects of percutaneous reconstruction plate internal fixation in the treatment of unstable sacral fractures. METHODS: Percutaneous reconstruction plate internal fixation was applied on 21 cases of unstable sacral fracture (15 males and six females, at age range of 16-65 years, mean 38.3 years) including four cases of Denis Zone I, 14 cases of Zone II and three cases of Zone III. In operation, an arc incision (about 3-5 cm long) was made along the iliac crest on the outside border of posterior superior iliac spine (PSIS) on both sides, and then the plate was transported from the wounded side to the opposite one through the subcutaneous tunnel. RESULTS:The mean incision length, operation time, intraoperative blood loss was 4.3cm, 45.2min, and 160.8ml respectively. All these patients were followed up for 12-33 months (average 16.3 months), which showed no incision infection, intraoperative neurovascular injury, internal fixation loose or breakage, disunion, or obvious lower limb length inequality. The function result was rated as excellent in six cases, good in 12 and fair in 3, with excellence rate of 85.7%, according to the Majeed scoring system. CONCLUSION: Percutaneous reconstruction plate internal fixation is an ideal surgical approach to unstable sacral fractures, as it is easy, safe, causing less trauma and fewer complications, and conducive to quicker recovery. Key words: Fracture Fixation, Internal. Reconstructive Surgical Procedures. Sacrum. RESUMO OBJETIVO:Estudar os efeitos da reconstrução percutânea com fixação de placa interna no tratamento de fraturas sacrais instáveis. MÉTODOS: A reconstrução percutânea com fixação de placa interna foi aplicada em 21 casos de fratura sacral instável (15 homens e seis mulheres, com idade variando entre 16 e 65 anos, média de 38,3 anos) incluindo quatro casos de Zona I de Denis, 14 casos de Zona II e três casos de Zona III. No ato operatório, uma incisão arqueada (cerca de 3 a 5cm de comprimento) foi feita ao longo da crista ilíaca na borda externa da espinha ilíaca supero-posterior (PSIS) em ambos os lados, e então a placa foi transportada do lado da ferida para o lado oposto através do túnel subcutâneo. RESULTADOS: O comprimento médio da incisão, tempo operatório e perda sanguínea intra-operatória foram, respectivamente, 4,3cm, 45,2min e 160,8ml. Todos estes pacientes foram acompanhados por 12 a 33 meses (média 16,3 meses), o que mostrou nenhuma infecção de ferida operatória, lesão neurovascular intraoperatória, perda da fixação interna ou quebra, desunião ou desigualdade nos comprimentos dos membros inferiores. O resultado funcional foi excelente em seis casos, bom em doze e falho em três, com taxa excelente de 85,7%, de acordo com o sistema de escore de Majeed. CONCLUSÃO: Reconstrução percutânea com fixação de placa interna é uma abordagem cirúrgica ideal para fraturas sacrais instáveis, sendo fácil e segura, causando menos trauma e poucas complicações, conduzindo a uma recuperação mais rápida. Descritores: Fixação Interna de Fratura...

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Management of traumatic spinopelvic dissociations: review of the literature

Lehmann

Hoffmann

Briem

et al. 2012

Eur J Trauma Emerg Surg

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Shortening Osteotomy and Sacro-sacral Fixation For U-shaped Sacral Fractures

Abstract: Performing the osteotomy helps in the reduction and allows a short fixation, which spares the mobility of the lumbo-sacral junction.

Cited by 16 publications

References 19 publications

Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies

Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies

Treatment of unstable sacral fractures with percutaneous reconstruction plate internal fixation

Management of traumatic spinopelvic dissociations: review of the literature

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